No abstract available.
Epidemiology* ; Hip Fractures* ; Hip*

The patella is an important component of the extensor mechanism of the knee. It serves to increase the mechanical advantage of the quadriceps muscle by increasing its lever arm. Therefore, if possible, when the patella is fractured, it should be repaired rather than excised. Present surgical techniques for the patellar fractures utilizes principles of anatomic reduction with repair of any associated retinacular tears, rigid internal fixation, and early institution of joint motion exercises. To compare the efficacies of the commonly used wiring techniques, we performed tension tests with transversely bisected patellar models fixed with circumferential wiring, Magnuson wiring, modified tension band wiring and modified tension band wiring combined with circumferential wiring. Also, we reviewed 66 surgically treated patellar fractures from Jan. 1984 to Dec. 1988, when we had given every effort to preserve the patella using modified tension band wiring or modified tension band wiring combined with circumferential wiring. l. According to the results of the tension tests, modified tension band wiring and Magnuson wiring were more rigid than circumferential wiring and the rigidity of modified tension band wiring was much increased when combined with circumferential wiring. 2. Of the 66 cases, 46 cases were treated with modified tension band wiring combined with circumferential wiring, and the remainder were treated with modified tension band wiring. 3. On the whole, good and excellent results were achieved in 87.9% (58 cases). Unsatisfactory results were obtained in 15.0% of cases treated with modified tension band wiring and in 10.9% of cases treated with modified tension band wiring combined with circumferential wiring. 4. Most of the unsatisfactory cases were so severely comminuted that could not be achieved anatomic reduction, rigid internal fixation and early joint motion exercises.
Arm ; Exercise ; Joints ; Knee ; Methods ; Patella ; Quadriceps Muscle ; Tears

In the assessment of thoracolumbar fractures, computed tomography (CT) is superior to other imaging modalities especially when a more definitive assessment of the posterior elements of the spine or the neural canal is desired. We evaluated 55 patients with acute thoracolumbar burst fractures, and correlated the amount of neural canal impingement (NCI), demonstrated on computed tomographic scans, with each patients neurologic status, level of injury and extent of recovery when neural deficit was present. The results were as follows ; l. Average NCI was significantly higher in cases with neurologic deficits (57.3%) than in cases with no deficit (29.8%). But the range of NCI was much overlapped between the two groups (32-100% with deficits vs. 8-69% with no deficit). 2. In cases with neurologic deficits, average NCI was significantly higher in lumbar spine (75.0%, range; 61-100%) than in thoracolumbar spine (49.2%, range; 32-87%). 3. There was no neurologic deficit in cases with NCI less than 30% in thoracolumbar spine and less than 60% in lumbar spine. 4. In thoracolumbar spine, there was more significant relationship between NCI and patient's neurologic status in T12 than in Ll. 5. The NCI did not directly correlate with the extent of recovery of neurologic deficits when present.
Humans ; Neural Tube ; Neurologic Manifestations ; Spine

BACKGROUND: In order to reduce the diagnostic window period between the time of human immunodeficiency virus (HIV) infection and serological diagnosis, new fourth generation screening assays which detect HIV p24 antigen and specific antibody simultaneously have been developed. In this study, we evaluated the performance of a new fourth generation assay. METHODS: We compared a new fourth generation assay, Architect HIV Ag/Ab combo, with another fourth generation assay AxSYM HIV Ag/Ab combo and a third generation assay, AxSYM HIV 1/2 gO for their performance. The assays were evaluated using 3 HIV seroconversion panels, 305 sera of healthy subjects and 100 sera of patients with HBsAg or anti-HCV antibodies. Within-run and total coefficient variations of the three screening assays were analyzed for the evaluation of precision. RESULTS: Architect HIV Ag/Ab combo shortened the window period by 8.7+/-2.1 days relative to AxSYM HIV 1/2 gO and 2.0+/-2.0 days relative to AxSYM HIV Ag/Ab combo in seroconversion panels. Architect HIV Ag/Ab combo presented the best performance in precision among the three reagents; total CV for positive control was 3.6%, 9.6% and 4.6% for Architect HIV Ag/Ab combo, AxSYM HIV Ag/Ab combo and AxSYM HIV 1/2 gO, respectively. Specificities of three assays were not different in this study. CONCLUSIONS: HIV Ag/Ab combined assays reduced the diagnostic window as compared to the third generation screening assays, enabling an earlier diagnosis of HIV infection. A new fourth generation assay, Architect HIV Ag/Ab combo presents a better performance than AxSYM HIV Ag/Ab combo, showing improved seroconversion sensitivity and precision.
Diagnosis ; Hepatitis B Surface Antigens ; Hepatitis C Antibodies ; HIV Core Protein p24 ; HIV Infections ; HIV Seropositivity ; HIV* ; Humans ; Indicators and Reagents ; Mass Screening

We describe two cases of chronic lymphocytic leukemia (CLL) with spuriously increased neutrophil count by the Sysmex SE-9000 hematology analyzer. Each case showed an excess of small lymphocytic cells in blood film microscopy, and a large group of plots in the lymphocyte area was observed on the differential scattergram of the SE-9000. In the cases of CLL, there is a possibility of overestimation of neutrophil count by the SE-9000. Microscopic examination and review of differential scattergram of the SE-9000 are necessary in the cases with increased leukocyte count.
Hematology* ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Leukocyte Count ; Lymphocytes ; Microscopy ; Neutrophils*

BACKGROUND/AIMS: ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) has been suggested as a reliable imaging technique for monitoring of disease activity in patients with adult-onset Still’s disease (AOSD). Therefore, we investigated the clinical significance of ¹⁸F-FDG PET/CT in Korean AOSD patients. METHODS: Thirteen AOSD patients were included in the study. The PET/CT images were evaluated with visual and semiquantitative method using standardized uptake values (SUVs). RESULTS: The presence of increased ¹⁸F-FDG uptake was noted in 90% of clinically active AOSD patients. ¹⁸F-FDG uptake was located in the lymph node, spleen, and bone marrow. Visual grade and SUV intensity of lymph node was significantly correlated with the systemic score of AOSD. Visual grade of spleen was significantly correlated with the systemic score, erythrocyte sedimentation rate (ESR), and ferritin. Additionally, visual grade and SUV intensity of bone marrow was significantly correlated with the systemic score, ESR, leukocyte, and neutrophil. CONCLUSIONS: Visual grade and SUV intensity of lymph node, spleen, and bone marrow on ¹⁸F-FDG PET/CT scan showed significant correlations with known disease activity markers. The data suggest that ¹⁸F-FDG PET/CT scan may be a useful imaging technique for evaluation of disease activity in AOSD patients.
Blood Sedimentation ; Bone Marrow ; Electrons* ; Ferritins ; Humans ; Leukocytes ; Lymph Nodes ; Methods ; Neutrophils ; Positron-Emission Tomography and Computed Tomography ; Positron-Emission Tomography* ; Spleen

No abstract available.
B-Lymphocytes* ; Bone Marrow* ; Genes, Immunoglobulin* ; Immunoglobulins* ; Lymphoma, Non-Hodgkin* ; Multiplex Polymerase Chain Reaction*

OBJECTIVE: Rheumatoid arthritis (RA) is the most common rheumatic disease but its diagnosis primarily relies on clinical disease manifestations. The serologic support is restricted to the determination of rheumatoid factor (RF), of which diagnostic ability is far from satisfaction. We compared the usefulness of a new serologic test, anti-cyclic citrullinated peptide antibodies (anti-CCP) for the diagnosis of RA with RF. METHODS: Anti-CCP antibodies were determined in 220 serum samples; 134 from RA patients and 86 from controls including 33 healthy controls and 53 patients with other diseases. Of 33 sera of the healthy controls, 12 were RF positive, which were intentionally included for the better analysis of specificities. Anti-CCP was done with the enzyme-linked immunosorbent assay (ELISA). RF was also assayed in every sample, and results were compared to anti-CCP for sensitivity and specificity. RESULTS: On each receiver operating characteristic curve, the area of under the curve was 0.843+/-0.028 for anti-CCP and 0.741+/-0.033 for RF. At each optimum cut-off value, the sensitivity of anti-CCP was comparable to that of RF (76.1% vs 67.2%) and the specificity of anti-CCP was better than that of RF (94.2% vs 74.4%, p<0.001). Importantly, 18 of 38 (47.4%) sera from RA patients negative for RF were positive for anti-CCP. Only one of 12 sera from healthy controls positive for RF was positive for anti-CCP. CONCLUSION: The anti-CCP ELISA showed high sensitivity even in RF negative RA patients, and very high specificity in healthy controls and disease control groups. The anti-CCP ELISA appeared a very useful new diagnostic test for RA. ivity.
Antibodies ; Arthritis, Rheumatoid ; Autoantibodies ; Diagnosis ; Diagnostic Tests, Routine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intention ; Lupus Erythematosus, Systemic* ; Rheumatic Diseases ; Rheumatoid Factor ; ROC Curve ; Sensitivity and Specificity ; Serologic Tests

Amyloidosis is a rare disease defined by extracellular deposits of amorphous fibrillar proteins, derived from aggregations of misfolded proteins. Localization of amyloidosis in the gallbladder is uncommon; only eight cases have been reported. We describe a case of amyloidosis diagnosed by cholecystectomy, which possibly also affected the liver and kidney. The patient was misdiagnosed with polymyalgia rheumatica, but after a cholecystectomy to treat chronic cholecystitis, we ultimately diagnosed him with amyloidosis. We review amyloidosis with gallbladder involvement in the literature.
Amyloidosis* ; Cholecystectomy ; Cholecystitis* ; Gallbladder ; Humans ; Kidney ; Liver ; Polymyalgia Rheumatica* ; Rare Diseases

INTRODUCTION: The ABX Pentra DX 120 (Pentra DX 120, ABX Diagnostics, Montpellier, France) adopted new technologies to perform differential leukocyte and erythroblast counts. The double matrix can discriminate Large Immature Cell (LIC), Immature Granulocyte (IMG), Immature Monocyte (IMM), Immature Lymphocyte (IML), and Atypical lymphocyte (ALY) in addition to a routine 5-differential count. For erythroblast (ERB), a fluorescence method is employed. In this study, we evaluated the performance of the Pentra DX 120 in the performance of differential leukocyte and erythroblast counts. METHODS: Precision was evaluated using 3-level control materials. Comparison analysis was performed on 200 samples: 100 normal and 100 abnormal samples. We evaluated the 5 part differential count, LIC, IMG, IMM, IML, ALY, and ERB. These parameters were analyzed in comparison with the results from the reference method, manual differential count. RESULTS: The coefficients of variation (CVs) of precision were <5% for neutrophils and lymphocytes, <15% for eosinophils and basophils and <7% for erythroblasts. The correlation coefficients (r) were >0.9 except monocytes and basophils. IMG, ALY and erythroblasts were also well correlated with manual count (r=0.8315, 0.5602, 0.8144, respectively). The efficiency of flagging system was 84% for LIC, 80% for ALY, and 78.0% for increased ERB (>2/100WBCs). CONCLUSIONS: The Pentra DX 120 performed reliable differential leukocyte and IMG, ALY, and ERB results demonstrated comparable performance to manual count. And, the flagging system was efficient for detecting each abnormal cell population. We expect the Pentra DX 120 double matrix and erythroblast count can reduce microscopic review rate in routine laboratory and promote laboratory efficiency.
Basophils ; Eosinophils ; Erythroblasts ; Fluorescence ; Granulocytes ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils